Are you taking HCTZ or HCT? Those are the abbreviations for hydrochlorothiazide. This “thiazide” diuretic is probably one of the most prescribed drugs in the world. By our count, over 20 million people pop a medication containing HCT every day in the U.S. It is found in lisinopril HCTZ, losartan HCTZ, triamterene HCTZ and valsartan HCT among many others. The diuretic raises uric acid levels. The result: hydrochlorothiazide triggers gout.

A Question from a Reader:

Q. I took hydrochlorothiazide (HCTZ) for about 15 years to lower my high blood pressure. Soon after I started taking it, I began experiencing episodes of gout.

Belatedly, I put the pieces together and realized that HCTZ was a major contributor to my gout.

Now I take tart cherries to lower my chances of gout and I have lost weight to bring my blood pressure down into normal range.

A. Gout is caused by a buildup of uric acid crystals in the joints. Since HCTZ can raise uric acid levels in the blood, it very well may contribute to gout. Congratulations on the healthy weight loss. Losing pounds can often bring blood pressure down.

Other Stories from Readers:

Jack in Marianna, Florida had an interesting roller coaster ride with HCTZ:

I have serious gout! The HCTZ is a major contributor to gout attacks. Doesn’t cause gout but increases the frequency and severity of attacks. I started HCTZ 15 years ago, and I also started having the violent attacks of gout then as well. I never knew the correlation until last month. I stopped HCTZ and replaced it with another medication and my gout attacks have subsided. Just saying.”

Tony also wasn’t told that hydrochlorothiazide triggers gout:

I was on HCTZ for more than 10 years. I suffered thru many episodes of gout, before I discovered that the HCTZ raised my uric Acid levels.

“I discussed this with my Internist, and he said he could put me on allopurinol [to lower uric acid levels] or take me off of the HCTZ. I chose the latter.”

Gout is Serious!

The pain of a gout attack can be unbearable. Gout can also damage joints. Although there are ways to lower uric acid levels it has always seemed a bit odd to us to try to counteract a side effect with another medicine.

If hydrochlorothiazide triggers gout in a person do health professionals really want to add allopurinol to solve that problem. Allopurinol can cause its own side effects including digestive tract upset, nausea, diarrhea, rash, itching, drowsiness, kidney and liver damage.

Tart Cherries for Gout:

Health professionals often think first of drug solutions for gout. We understand that. Medical education emphasizes pharmaceutical answers to common ailments. When non-drug options are discussed, many physicians assume that there is no science to support them. In the case of tart cherry juice, au contraire.

Stories from Readers:

Not everyone benefits from tart cherry juice. Let’s be totally clear about that. Some people do appear to get relief, however.

Linda in Wisconsin had success:

I have had gout a couple of times and since my parents too had suffered from gout I took my mom’s advice and drank the cherry juice. It works!!! That was years ago and if ever I have an inkling of the possibility of another attack I start drinking cherry juice.”

Eloise overcame a gout attack:

My first attack of gout came after I went on what I thought of as a health kick with lots of beans and peas at two meals a day. I did this for a week or so, but hadn’t yet gotten control of my soda habit (one step at a time, right?). The combination was a bad one, and I was soon in excruciating pain!

“Luckily, I had heard about Trader Joe’s Morello cherries. They’re cheap (about $3 for a large jar) and worked miraculously! I ate about a dozen, and within a couple of hours I started to feel relief.

“The pain was completely gone the next day! If it started to flare up, I ate 6 more and was completely back to normal in 3 or 4 days. I now keep them on hand, and if I ever feel an attack come on, I immediately run for my “magic cherries.” They’ve worked without fail!”

Celery Seed Extract for Gout?

Brett in Wisconsin shared this experience:

I was a long-time user of Allopurinol, and it was very successful in managing gout. However, I am not in favor of taking any medications if I can find an alternative. Last December I had a situation where my Allopurinol was misplaced. I was traveling so I had to go without for a week. At that time I decided to stay off the Allopurinol and try Celery Seed Extract. Four months later I have yet to have a flare up. My uric acid levels are normal and no prescriptions!”

People’s Pharmacy Perspective:

Hydrochlorothiazide triggers gout. There is no controversy about that, though some health professionals think it is a very rare side effects. A systematic review of the medical literature, however, describes thiazide diuretics like HCTZ as important contributing factors in raising uric acid levels and causing gout attacks (Current Opinion in Rheumatology, March, 2011):

Among medications, consistent evidence exists for thiazide and loop diuretics to be associated with higher risk of incident gout and higher rate of gout flares.”

Patients taking thiazide diuretics like HCTZ should have uric acid levels tested periodically. If they experience a gout attack they should discuss this adverse reaction with the prescribing physician to see if another medication might be more appropriate.

Related People's Pharmacy Health Guide

Download these eight pages on the pros and cons of the various medicines used to lower blood pressure. Details on non-drug approaches to blood pressure control such as diet, supplements and special foods.

15 Thoughts Shared

Peggy

Washington

March 6, 2018 at 8:32 pm

I was put on HCTZ because my bp was 150/87, and I had just dropped off school kids! In my opinion, 10 years later, being diagnosed with type 2 D almost right away, and ending up with a very bad rash on both buttocks, after subscribing to TPCN, I went off HCTZ and went to Beet Juice which I Juice myself. I am fine now, BP averages 123/79. I lost weight and am very active. I have NEVER taken any medicine for Diabetes and am controlling it with food. Salmon, fish, and of course lots of cinnamon. At age 77, I am very healthy, and I eat what I want in MODERATION!

Conrad

NY

February 13, 2018 at 11:57 pm

MDs are not taught enough about how certain BP meds can cause serious side effects like painful gout attacks and Big Pharma doesn’t mind. Pharma does some wonderful things, but they are also a huge profit making industry.

Jeff, RN

Charlottesville, VA

February 9, 2018 at 10:39 am

I am one of those who gets a benefit from frequent doses of tart cherry juice that I make as a flavored seltzer. I learned about the treatment from the People’s Pharmacy and have not have a gout attach, thank goodness, for years. I make a fairly dilute drink but use it as my source of hydration fluids. And yes, I was on HCTZ so it made sense. Of course there is also some evidence that the high potassium in tart cherry juice helps lower blood pressure. Win-Win

Ron

SoCal

February 7, 2018 at 4:12 pm

Cheryl

February 7, 2018 at 11:08 am

Anyone have experience weaning off Humira to a lower cost solution for RA? Low dose naltrxone was suggested by a friend with MS but I’ve not been able to consult with my rheumatologist yet.
Don’t want to pay for high priced tier 5 meds now that I no longer have excellent coverage through my former employer.

Barbara

New York

February 6, 2018 at 1:26 pm

February 11, 2018 at 3:27 pm

Like gout, pseudogout is a condition that causes sudden severe pain in a joint (for pseudogout, often a knee). In both cases, the cause is crystals precipitating into the joint. In gout, they are monosodium urate (uric acid) crystals. In pseudogout, calcium pyrophosphate crystals. Doctors prescribe NSAIDs and colchicine for pseudogout as well as for gout.

Ice packs may help the pain. No one seems to have written about whether tart cherries can help.

Chris B

Durham, NC

March 28, 2018 at 7:33 pm

Wendy

Friendswood, tx

February 6, 2018 at 12:33 pm

One caution about suddenly stopping HCTZ. My dr took me off of it without tapering and I looked like the pillsbury dough boy! I had a rebound with extreme water retention. IMO doctors are really bad at not considering rebound effects when stopping meds.

Sharon

February 6, 2018 at 11:24 am

I also take HCTZ for blood pressure and know that it causes skin cancer, but niacinamide counters that so I have started taking it. I never miss “The People’s Pharmacy.” Even if the topic is one I think doesn”t pertains to me I learn something. Thank you!

Steve

Maryland

February 6, 2018 at 9:30 am

I too have had gout attacks in the past. My father had gout, and it looks like it is my burden also. I have tried cherries and a number of other remedies and did not have much luck. A couple years ago I discovered Terminalia bellirica. Medical literature and double blind testing found this to be a very effective alternative to prescription drugs. Obviously, it takes a bit longer to be effective but effective it is. I have not had a gout attack in two years. One capsule in the morning and one at dinner time does the trick..

In the past I had bouts that would last for weeks. One of the most severe pains I have ever felt. Medical literature indicates no reported adverse reactions nor does it appear to have any caution about other systems such as the liver.

Marilyn

Indiana

February 5, 2018 at 10:40 pm

We invite you to share your thoughts with others, but remember that our comment section is a public forum. Please do not use your full first and last name if you want to keep details of your medical history anonymous. A first name and last initial or a pseudonym is acceptable. Advice from other commenters on this website is not a substitute for medical attention. Do not stop any medicine without checking with the prescriber. Stopping medication suddenly could result in serious harm. We expect comments to be civil in tone and language. By commenting, you agree to abide by our commenting policy and website terms & conditions. Comments that do not follow these policies will not be posted. Learn how your comment data is processed.

Name

Email

Location

About the Author

Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” Read Joe's Full Bio.